Handheld cyrogenic treatment systems

Abstract

Methods and apparatus for the treatment of a body cavity or lumen are described where a heated fluid and/or gas may be introduced through a catheter and into treatment area within the body contained between one or more inflatable/expandable members. The catheter may also have optional pressure and temperature sensing elements which may allow for control of the pressure and temperature within the treatment zone and also prevent the pressure from exceeding a pressure of the inflatable/expandable members to thereby contain the treatment area between these inflatable/expandable members. Optionally, a chilled, room temperature, or warmed fluid such as water may then be used to rapidly terminate the treatment session.

What is claimed is: 
     
       1. A handheld tissue treatment system, comprising:
 a handle having a housing; 
 an elongate probe having a distal tip and a flexible length extending from the handle; 
 at least one infusion lumen aligned along a side of the elongate probe and extending towards the distal tip of the probe, wherein the infusion lumen defines a plurality of openings along its length; 
 at least one delivery lumen slidingly positioned through or along the infusion lumen, wherein proximal translation of the delivery lumen relative to the infusion lumen increases a number of unobstructed openings along the infusion lumen and distal translation of the delivery lumen relative to the infusion lumen decreases the number of unobstructed openings along the infusion lumen; 
 a liner expendably enclosing the probe; and 
 a reservoir containing a cryoablative fluid or gas which is integrated into or along the housing and in fluid communication with the at least one infusion lumen such that the cryoablative fluid or gas flows from the reservoir and laterally through the unobstructed openings along the infusion line and coats an interior wall of the liner. 
 
     
     
       2. The system of  claim 1  wherein the elongate probe defines an exhaust lumen for the cryoablative fluid or gas. 
     
     
       3. The system of  claim 1  wherein the infusion lumen and delivery lumen are in fluid communication with one another. 
     
     
       4. The system of  claim 1  wherein the plurality of openings along the infusion lumen are defined opposite to one another along the infusion lumen. 
     
     
       5. The system of  claim 1  wherein the delivery lumen comprises a Nitinol delivery tube slidingly positioned through the infusion lumen. 
     
     
       6. The system of  claim 1  wherein the elongate probe defines a plurality of patterned slots along an anterior or a posterior surface. 
     
     
       7. The system of  claim 1  wherein the elongate probe is configured to bend within a single plane. 
     
     
       8. The system of  claim 1  wherein the cryoablative fluid or gas comprises nitrous oxide. 
     
     
       9. The system of  claim 1  wherein the infusion lumen defines an active treatment portion near or at the distal tip. 
     
     
       10. The system of  claim 1  further comprising a sheath assembly slidably positioned over the elongate probe. 
     
     
       11. The system of  claim 1  further comprising a pump in fluid communication with the liner interior. 
     
     
       12. The system of  claim 1  wherein the liner comprises at least two tapered portions extending from the distal end of the elongate probe such that the tapered portions are configured to contact a corresponding uterine cornu. 
     
     
       13. A method of treating tissue, comprising:
 positioning an elongate probe extending from a handle into a body lumen to be treated; 
 expanding, a liner enclosing the probe into contact against the body lumen; 
 adjusting, a position of a delivery lumen relative to an infusion lumen which is aligned along a side of the elongate probe and extends towards a distal tip of the probe, wherein the infusion lumen defines a plurality of openings along a length of the infusion lumen such that proximal translation of the delivery lumen relative to the infusion lumen increases a number of unobstructed openings along the infusion lumen and distal translation of the delivery lumen relative to the infusion lumen decreases the number of unobstructed openings along the infusion lumen; and, 
 infusing a cryoablative fluid or gas from a reservoir and through the delivery lumen such that the fluid or gas passes into the infusion lumen, laterally through the unobstructed openings, and coats an interior of the liner. 
 
     
     
       14. The method of  claim 13  further comprising withdrawing the cryoablative fluid or gas from the interior of the liner. 
     
     
       15. The method of  claim 13  wherein expanding a liner comprises infusing one or more puffs of air into the liner until the liner conforms to the body lumen. 
     
     
       16. The method of  claim 13  wherein adjusting a position of a delivery lumen comprises translating the delivery lumen through the infusion lumen to selectively obstruct the plurality of openings. 
     
     
       17. The method of  claim 13  wherein infusing a cryoablative fluid or gas comprises infusing nitrous oxide into the interior of the liner. 
     
     
       18. The method of  claim 13  further comprising ceasing infusion of the cryoablative fluid or gas and evacuating the interior of the liner through the elongate probe. 
     
     
       19. The method of  claim 13  further comprising monitoring a pressure of the interior of the liner while infusing the cryoablative fluid or gas. 
     
     
       20. The method of  claim 13  wherein expanding a liner further comprises detecting for a leak.